I am presently using a prescription for estrogen cream to relieve symptoms of thin and dry vaginal tissue due to breastfeeding. My son is 9 weeks old (I just started using the cream). The package insert groups this medication with oral estrogen medications when describing side effects. These include things like depression and others common to birth control pills. I am also taking the mini pill to prevent pregnancy. Is anything specific known about the absorption of estrogen from the cream? Is there any chance that these hormones, either alone or together, could have a detrimental effect on my milk supply? My son has fed and grown well so far. The instructions for the cream are to use it daily for two weeks then every third day or so after that.
Vaginal dryness can be common in the months following your baby's birth. It is normal for a woman's estrogen levels to be low at this time. Though most women will not find it necessary to use an estrogen cream (available only by prescription), a study by Wisniewski and Wilkinson in 1991, found estrogen-based creams did not have any noticeable effect on lactation. For a non-prescription alternative you could try a water-based lubricant, such as Astroglide, for vaginal dryness.
Studies generally show the mini-pill (progestin-only birth control pills) to have minimal effect on lactation, but in practice some Lactation Consultants see even these reducing a mother's milk supply, especially during the early months of breastfeeding. There is also thought to be some change in composition of your breastmilk (protein and fat content) when using hormonal contraceptives, but the significance of this change is not clear.
When choosing a hormonal method of birth control, it is particularly important to keep an eye on your baby's output and pattern of weight gain. Babies over 6 weeks of age should be wetting 5 to 6 diapers each day, and having regular, substantial bowel movements. During a baby's first 3 to 4 months, of life, normal weight gain is between 4 and 8 ounces a week. If you see your baby's output or weight gain pattern deviating from the norm, it is important to talk this over with your Health Care Providers (and possibly choose a non-hormonal method of birth control.) Best wishes!
